Diabetes linked to rural–urban migration

[NEW DELHI] The obesity and diabetes epidemic in India is strongly associated with rural–urban migration, a new study has found.

The study, published last month (27 April) in PLoS Medicine involved over 6,500 participants that included both migrants as well their non-migrant, rural relatives.

"Migrants develop levels of obesity and diabetes similar to the urban dwellers they live and work with, but their rural dwelling brothers and sisters tend to stay less obese and have lower rates of diabetes," lead author Shah Ebrahim, professor of public health at the London School of Hygiene and Tropical Disease, said.

The study found that 41.9 per cent of urban men and 37.8 per cent of migrant men were obese. In contrast, only 19 per cent of the rural men were obese. Similarly, 13.5 per cent and 14.3 per cent of the urban and migrant men, respectively, but only 6.2 per cent of the rural men had diabetes. The figures were similar for the women participants.

The main triggers were increased calorie intake and reduced physical activity associated with urban lifestyles and disposable incomes, Ebrahim said.

However, there was negligible difference in obesity and diabetes levels between recent migrants and older migrants who had moved in 10 years previously, suggesting an immediate adjusting period to urban lifestyles that should be targeted in prevention programmes.

"Targeting prevention programmes on migrants could be a very good occupational health strategy. Factories are magnets for migrants and most need to have a health promotion component," Ebrahim said

The proportion of India's population with diabetes has been increasing steadily in urban areas, up from five per cent in 1984 to 15 per cent in 2004; while its prevalence is now six per cent in rural areas.

"We have known earlier that migration has a profound impact on obesity and diabetes. But what is relatively new is risk imparted by migration from rural to urban areas," Anoop Misra, director and head of the department of diabetes and metabolic diseases at the Fortis Hospitals in New Delhi and former head of the department of medicine at the All India Institute of Medical Sciences, told SciDev.Net.